Diabetic ketoacidosis (DKA) is an acute life-threatening complication occurring mainly at the onset of type 1 diabetes mellitus. The neutrophil-to-lymphocyte ratio (NLR), a marker for systemic inflammation, has recently generated increasing interest in many chronic diseases. The aim of this cross-sectional study was to determine the value of the neutrophil-to-lymphocyte ratio (NLR) in association with DKA severity across these cases. A total of 155 children with new-onset type 1 DM from one large center were included in the study. Total and differential leukocyte counts were measured upon admission and calculation of the NLR was performed. Patients were classified into four groups: without DKA, mild, moderate, and severe DKA at disease onset. Total WBCs, neutrophils, and monocytes increased with DKA severity (p-value < 0.005), while eosinophiles displayed an inverse relationship (p-value < 0.001). Median NLR scores increased from those without ketoacidosis (1.11) to mild (1.58), moderate (3.71), and severe (5.77) ketoacidosis groups. The statistical threshold value of the NLR in predicting DKA was 1.84, with a sensitivity of 80.2% and a specificity of 80%. Study findings indicate that a higher NLR score adds valuable information regarding the presence of DKA in children with new-onset T1DM.
Objective: To investigate the relationship between markers of adiposity and common carotid artery (CIMT) in obese children born small for gestational age (SGA) versus appropriate for gestational age (AGA), to establish cut-off values for CIMT in obese pediatric populations. Subjects and methods: A cross-sectional study was carried out over a 1-year period (Jul 2013 -June 2014). We analyzed 122 obese patients aged 4-20 (mean age 14.9 ± 2.28). Twenty-six patients were born SGA. CIMT was measured in all the patients. Using ROC curve, cut-off values were obtained for both groups. Results: We demonstrated a correlation between CIMT and adiponectin, leptin and high sensitivity C-reactive protein (hsCRP) (r = -0.25, r = 0.279, r = 0.498) in obese children. CIMT in obese children born SGA were significantly increased as compared with obese children born AGA of similar age, sex and body mass index (BMI) (p = 0.0035). A CIMT cut off value of 0.049 cm has been obtained with a high sensitivity and specificity. Conclusion: CIMT is a well-known marker of subclinical atherosclerosis and its measurement is a noninvasive and inexpensive method of detecting subclinical atherosclerosis. Being born SGA increases the atherogenic risk. Obese children with CIMT above 0.049 cm should be screened for metabolic syndrome (MetS).
Indicele intimǎ medie carotidian (IMc) este un cunoscut marker subclinic pentru aterosclerozǎ. Fenomenul de recuperare nutriţionalǎ la copiii nǎscuţi mici pentru vârsta gestaţionalǎ (SGA) a fost asociat cu obezitate precoce şi cu riscul dezvoltǎrii sindromului metabolic. Scop. De a determina dacǎ existǎ o asociere între SGA şi IMc; de a stabili valori prag ale IMc la copiii obezi. Material şi metodǎ. Studiul prospectiv a fot derulat pe o perioadǎ de un an (iulie 2012 – iunie 2013). Au fost analizaţi 122 de pacienţi cu obezitate, 96 de pacienţi nǎscuţi cu greutate normalǎ pentru naştere (AGA) şi 26 de pacienţi nǎscuţi cu greutate micǎ pentru naştere (SGA). Ambele loturi au fost omogene din punct de vedere al vârstei, sexului şi indicelui de masǎ corporalǎ (IMC). Folosind curba ROC au fost stabilite valori prag pentru ambele grupe. IMc a fost semnificativ mai crescut la lotul SGA (p = 0,0035). Valoarea prag de 0,049 cm pentru IMc a fost obţinutǎ la ambele loturi, cumulat, cu o specificitate şi sensibilitate crescutǎ. Concluzii. Copiii nǎscuţi SGA se asociazǎ cu risc aterosclerotic. IMc este un cunoscut marker subclinic pentru aterosclerozǎ, fiind o metodǎ ieftinǎ şi noninvazivǎ. Studii populaţionale extinse sunt necesare în vederea stabilirii unor valori prag în ceea ce priveşte IMc.
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